Media Project Reflection

The most meaningful and significant thing I discovered from this media project was a creative part of myself that I didn't know ever existed. Posterboard projects have always been the bane of my existence! To take it a step further, we were challenged to create our own invention that could be used as a part of an OT intervention for a specific case study. The catch was that it was a mundane, everyday item which could not be used for its original purpose. How was I supposed to make a sriracha bottle fun, purposeful, and meaningful?! After brainstorming for what seemed like such a long time, it finally all came together. Through this, I discovered that anything can be used for OT. It is so easy to pick up an everyday object and consider only using it for what it is originally meant for. Through the lens of OT, it is up to us make the therapeutic process something that can be fun and enjoyable so that clients are more inclined to participate, learn, and receive effective treatment. Now I'm able to see everyday objects from a new perspective - one where there is an opportunity for a purposeful therapeutic activity anywhere. 

I was challenged, forced out of my comfort zone, and the outcome was growth. I never considered myself to be a creative person ("I'd rather write a 10-page paper!") and this really helped to strengthen my "OT brain". It allowed me to really and truly consider the client. What on earth could they possibly do with this that they would actually find enjoyable? It was easy for me to think of ways to manipulate the sriracha bottle for physical therapeutic purposes, but that was not the goal here. I needed to make it purposeful and meaningful. Ultimately, it encouraged a genuine, client-centered approach. I realize that I am able to be creative if I put forth the effort and as a result, become a more well-rounded individual, OT student, and future practitioner.

This project was a good introduction and first-time experience in developing a hypothetical intervention for a client that has both a means and an end. It helped me in becoming more familiar with the OT process and what it means and takes to be an OT. Seeing others' projects was very eye-opening, as well. Who knew that everyday items that we normally don't think twice about could be used in such a purposeful way? This just goes to show that OT can be for anybody with the ability to effectively use no/low-tech equipment and find the "just right" fit for someone. This assignment was an amazing opportunity to practice creativity which is essential as an OT. Going forward, and as I become more familiar with this process, I will be able to implement these skills in future classes and clinical practice.

~ Pam ♡

The Dementia Village

TEDTalk | Yvonne van Amerogen | The "dementia village" that's redefining elder care

Occupational Therapy (OT) "has to do with looking at the person in front of you and looking at what does this person need now" and seeing them as more than a diagnosis. Dementia is an incurable disease which affects the brain leading to confusion, and as a result, anxiety, depression, and aggression. The presence of dementia within the worldwide population is prominent. So much so, that it has become problematic resulting in waiting lists for nursing homes. Presently, nursing homes assume a clinical appearance such as a hospital or ward leaving patients more confused and with a desire to escape and "go home". Yvonne van Amerogen wanted to challenge the traditional structure of current nursing homes. Twenty-five years ago, she developed the Hogeweyk dementia care center in Amsterdam. This nursing home is occupied by residents with advanced dementia and who are fully dependent on other professionals for around-the-clock care and support. Hogeweyk imitates that of a regular community with streets, alleys, theaters, pubs, and more so that it may simulate and allow residents to partake in a normal lifestyle. 



The current environment of nursing homes is not ideal or desirable for friends, parents, family, or ourselves, and Yvonne pushed for a change. Although individuals with dementia experience general confusion, they still want a normal life. For example, they want a house with a kitchen with a stove where they can smell dinner and have the freedom to go get something to eat or drink. Future residents' family members such as their son or daughter were asked what is important to their mother or father, what was their life like before their diagnoses, and most importantly, what they want. From this information, residents are placed with a "lifestyle group". These are small groups comprised of ~7-8 people (as opposed to the traditional ~20-30 seen in nursing homes) with similar interests and lifestyles. For example, there is a Formal lifestyle group in which the residents wake up and go to sleep at later hours and have a more formal manner of interacting with others. There is also a Cultural lifestyle group for those who value traveling, meeting other people, and being exposed to different cultures, art, and music. 

People are social animals, and it is in our nature to want to have fun and develop meaning in life. Yvonne says that there is more to life than just living in a house with other people. In Hogeweyk, people can go shopping, go to the pub, go to a restaurant, or go to the park. Even in those with advanced dementia, socializing is a critical part of life. Here residents can have this feeling of belonging along with a natural sense of freedom and safety provided by trained volunteers and professionals who know how to approach dementia. Hogeweyk was created with state budget - the same budget as any other traditional nursing home in the country. This can be possible anywhere!

I chose to watch this TEDTalk because the title was interesting. As I was watching, I realized that this creation resonated and aligned perfectly with the meaning and purpose of OT. Hogeweyk aims to increase its residents quality of life by exposing them to a normal, social lifestyle that aids in facilitating independence. As an OT student and future practitioner, this gave me hope for a universal goal that is realistic. Instead of focusing on a diagnosis, this environment encourages and fully adopts a holistic approach to care for its residents as normal people with normal lifestyles. 

~ Pam ♡

Image retrieved from: Google Images
Amerongen, Y. (2018, November). The "dementia village" that's redefining elder care [Video file]. Retrieved from https://www.ted.com/talks/yvonne_van_amerongen_the_dementia_village_that_s_redefining_elder_care

3 Letters - ALS

TEDTalk | Scott Matzka | How 3 Letters Changed My Life

https://www.youtube.com/watch?v=NOK83OHmTbE

I have only had very superficial exposure to Amyotrophic Lateral Sclerosis (ALS) through the Ice Bucket Challenge, learning about it in class, and knowing about iconic people with the disease such as Lou Gehrig and Stephen Hawking. So, I chose to watch this TEDTalk in order to gain insight into someone's personal experience with ALS. 

Scott Matzka is a University of Michigan alumni, and played hockey for 11 years at the collegiate and professional level. He has been married to his wife for 7 years and is a father of two children. The initial signs and symptoms of ALS he experienced were forearm cramps, stiffness in his fingers, and muscle spasticity in his hands. After seeing a general doctor and after months of MRIs, blood tests, and examinations, he was referred to a neurologist and diagnosed with ALS. Five years prior to his diagnoses, Scott was in peak athletic condition, being able to run a 6-minute mile and hit a golf ball 300 yards. From then to 2017, there was a stark contrast. His day to day life was significantly impacted and he was faced with new challenges, including walking to the mailbox, dressing himself, holding utensils, and getting out of a car or up from a chair. 

When Scott was diagnosed, he knew he had to make a choice - to lie down or stand up. He resonated with other people who have been faced with a similar choice on how to proceed with life when they have had a life-changing event such as losing a loved one or having a career-ending injury. Although he knew he would never walk his daughter down the aisle or hold his future grandchildren, he chose to live life to the fullest. He considered keeping his diagnoses personal in fear of making others sad or upset. Instead, he chose to be vulnerable, and as a result, he strengthened his current relationships with his family, friends, and former teammates, and created new bonds with people he has never met from places he has never visit. With such a strong rapport for emotional support, they were able to build a bucket list and Scott found a new meaning to his life.

Through this encouragement, Scott founded "My Turn" which is a campaign to raise awareness and aid to the ALS cause. This turned into his life's purpose and reason for getting up every morning. Scott shared 2 lessons with his audience. Lesson 1: Vulnerability. If he had not shared his diagnoses with others, he would not have received such love and compassion from his loved ones, or have raised the extent of awareness he had. This leads to Lesson 2: Perspective. As a result of his vulnerability, he was able to change how others looked at and approached their own lives. This prompts the question - what would our life be like if we knew death was close, inevitable, and could occur at any given moment? Maybe we would see less of our daily exposure to terrorism and shootings, and maybe, instead, we would be kinder, more compassionate, and more generous toward others.

This video was so touching and deepened my empathy as an OT student and future practitioner to those with ALS, as well as others who may be experiencing a life-altering disease or injury. Upon being diagnosed, Scott was not informed by any medical professional or website on how to approach life after his diagnoses. No one told him "...that life goes on. They don't tell you that you have to keep on going... even that very same day." With our holistic approach, we as OT's can help and guide others through these emotions so that they can continue to live life to their fullest, possible potential. This gives our role a profound meaning and purpose that others cannot fulfill. By sharing his experience, Scott introduced a ripple effect so that we may continue to advocate for the ALS cause. Although Scott passed away in December of 2018, his legacy thrives and lives on through the lives of those he impacted. 

~ Pam ♡

Picture retrieved from: Google Images
TEDx Talks. (2017, March). How 3 Letters Changed My Life [Video file]. Retrieved from https://www.youtube.com/watch?v=NOK83OHmTbE

Spinal Cord Injury Lesions

There are many effects and ways to categorize the effects of spinal cord injury (SCI) lesions. For example, there are different syndromes that may stem as a result of an SCI lesion, such as Central Cord Syndrome, Brown-Sequard Syndrome, Anterior Cord Syndrome, Cauda Equina Syndrome, and Conus Medullaris. In order to assess the differing degrees and residual function after SCI, the American Spinal cord Injury Association (ASIA) Impairment Scale is utilized. It ranges from Level A to Level E with Level A being the most severe, indicating a complete SCI and no motor or sensory function in the lowest sacral segment of the spinal cord, and Level E indicates normal sensory and motor function with no spinal cord lesion. Depending on where the lesion occurs, upper and lower motor neuron (U/LMN) signs may be present. UPN originate from the brain and are responsible forsending signals to LMN. LMN are also known as spinal nerves and send the received signals directly to the desired target (e.g. muscle). If an UPN lesion occurs, one may experience spasticity below the level of the lesion and paralysis. On the other hand, one may experience hypotonicity (low muscle tone), muscle atrophy, and partial to no motor reflexes if the LMN is affected. A couple other hallmark conditions associated with SCI include neurogenic shock and autonomic dysreflexia. One may experience neurogenic (or spinal) shock immediately following a SCI leading to a loss of motor pathways, tendon reflexes, autonomic function, as well as causing flaccid paralysis. Neurogenic shock may last for hours, days, or weeks before spinal activity returns. Upon the return of this activity and usually at a SCI at T6 or above, autonomic reflexes return and may result in exaggerated sympathetic reflex responses known as autonomic dysreflexia. Signs associated with this include severe hypertension, profuse sweating, bradycardia, and vasodilation. Autonomic dysreflexia is considered to a clinical emergency that can result in death - when it occurs, it is crucial to immediately stop the individual’s activity, elevate his/her head to avoid excessive blood pressure to the brain, and loosen clothing and other constrictions.

~ Pam ♡

Image retrieved from: https://www.aans.org/Patients/Neurosurgical-Conditions-and-Treatments/Spinal-Cord-Injury

The Cure to Alzheimer's

The TED Talk by Samuel Cohen, “Alzheimer’s is not normal aging – and we can cure it,” caught my attention due to its bold title. I chose to watch this in hopes that I could make connections to our neuroscience class as well as apply any learnings as an occupational therapy student and future practitioner. As a major medical epidemic, it is inevitable as a future occupational therapist that I will connect with others diagnosed with this particular condition. However, Cohen states that by the year 2050, the number of people Alzheimer’s will affect compared to present-day will almost quadruple and the chance of developing this disease will be 1 in 2. 

Over a century ago, a medical case kindled the origins of Alzheimer’s disease. From a woman named Auguste’s experience, Dr. Alois Alzheimer discovered plaques and tangles – both contributing components involved in AD. Since then, there has been virtually no progress in the treatment of Alzheimer’s. To this day, it is one of the top 10 causes of death worldwide and the only one in this category that is still not preventable, curable, or able to be slowed down in its progression. In this TED Talk, Samuel Cohen argues that there is a cure that could come into existence but cannot be reached due to a lack of awareness, compared to other prevalent medical diagnoses such as cancer and HIV. This has been due to the misunderstanding and belief that the signs and symptomology of Alzheimer’s were merely indicative of someone becoming senile. It was not until the brain of a patient with Alzheimer’s and a brain of one without were compared that there is an observable physical difference between the two.

Cohen revealed for the very first time a new drug that he and his research team had developed which applied to worms at an early age, live a normal, healthy lifespan. He demonstrated this in order to illustrate that Alzheimer’s is a disease we are all able to understand and one day cure. Because we as practitioners are involved in the field of medicine and directly interact with others who may be diagnosed with Alzheimer’s, it is important to actively educate ourselves and play a key role in raising awareness. Today, there is such a diverse group of people contributing to this goal in order to transform it into a reality, including our very own occupational therapists.

Here is a link to the TED Talk if you would like to know more! https://www.ted.com/talks/samuel_cohen_alzheimer_s_is_not_normal_aging_and_we_can_cure_it/transcript?language=en

~ Pam ♡

Image retrieved from: https://www.williamsburglanding.org/article/10/6/2015/samuel-cohen-alzheimers-not-normal-aging-%E2%80%94-and-we-can-cure-it

Mobility Skill Progression

It is important to take the Hierarchy of Mobility Skills into consideration when working with a client in order to ensure safe and efficient treatment progress. The order from most basic to complex is as follows: bed mobility, mat transfer, wheelchair transfer, bed transfer, functional ambulation for ADL, toilet and tub transfer, car transfer, functional ambulation for community mobility, and community mobility and driving. From a personal and practical perspective, this sequence is understandable. Not only is bed mobility the most basic skill, but it also supplies the foundation on which other mobility skills can expound on. As the hierarchy ascends, the client's base of support decreases, which allows for increased mobility, however, consequently reducing stability as well. Namely, the ability to effectively and safely perform one mobility skill is dependent upon the mastery of the skill(s) associated with the tiers beneath it. 

It was eye-opening to have been able to better understand different mobility skills in simulated labs. The exposure to how debilitating even a simulated disability can be placed a lot into a different perspective. This order of attaining mobility skills is a very gradual progression in which levels could overlap. This helps to facilitate the fluid and natural development of said skills, and as a result, promotes the efficacy of treatment. Fortunately, in terms of personal observed clinical experiences, practitioners have done well to abide by this sequence. As future practitioners, it is imperative that we have a full, clear understanding of this hierarchy so that we may efficiently and holistically treat our clients.

~ Pam ♡

Image retrieved from: https://www.canstockphoto.com/disabled-wheelchair-kids-27985992.html